达芬奇单孔机器人系统经口机器人全喉切除术的可行性研究
Feasibility of Transoral Robotic Total Laryngectomy With the Da Vinci Single Port Robotic System.
文献信息
| PMID | 42829482 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Matthias De Witte |
| 作者单位 | Department of Otorhinolaryngology, Head and Neck Surgery AZ Sint-Jan Bruges Belgium. |
| 期刊 | Laryngoscope investigative otolaryngology |
| SCI 分区 | Q2 |
| IF | 2.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 评估使用达芬奇单孔（SP）机器人系统进行经口机器人全喉切除术的可行性，描述手术技术并讨论术后结果。
方法： 回顾了一例69岁女性右侧杓会厌襞复发性鳞状细胞癌的临床病例。在既往手术切除切缘阳性及有放化疗史后，使用达芬奇SP机器人平台进行了挽救性全喉切除术。该手术按照先前为多孔系统描述的改良经口机器人入路进行。
结果： 使用达芬奇SP系统经口机器人喉切除术顺利完成，无需转为传统开放入路。手术包括颈部解剖阶段、经口机器人切除、经口咽部重建和颈部关闭。机器人控制台总时间为51分钟。术后18天钡餐吞咽检查显示无瘘管形成迹象后恢复经口进食。随访6个月，未观察到局部区域复发或迟发并发症。
结论： 使用达芬奇SP系统进行经口机器人全喉切除术在技术上似乎是可行的，与传统开放入路和多孔机器人系统相比可能具有若干优势。这些优势包括改善的可视化、增强的器械可操作性、有限的颈部解剖和良好的功能恢复。需要更大规模的研究来评估可重复性、长期肿瘤学安全性和功能结果。
证据等级： 5。
英文摘要
OBJECTIVES: To evaluate the feasibility of transoral robotic total laryngectomy using the Da Vinci Single Port (SP) Robotic System, to describe the surgical technique and discuss postoperative outcomes.
METHODS: A clinical case of a 69-year-old woman with recurrent squamous cell carcinoma of the right aryepiglottic fold was reviewed. Following prior surgical resection with positive margins and a previous history of chemoradiotherapy, salvage total laryngectomy was performed using the Da Vinci SP robotic platform. The procedure was conducted following a modified transoral robotic approach previously described for multiport systems.
RESULTS: Transoral robotic laryngectomy using the Da Vinci SP system was accomplished without needing conversion to a conventional open approach. The procedure consisted of a cervical dissection phase, transoral robotic resection, transoral pharyngeal reconstruction, and cervical closure. Total robotic console time was 51 min. Oral intake was resumed after a barium swallow 18 days postoperatively showed no signs of fistulization. At 6 months follow-up, no locoregional recurrence or delayed complications were observed.
CONCLUSION: Transoral robotic total laryngectomy using the Da Vinci SP system appears technically feasible and may offer several advantages compared to conventional open approach and multiport robotic systems. These include improved visualization, enhanced instrument maneuverability, limited cervical dissection and favorable functional recovery. Larger studies are required to evaluate reproducibility, long-term oncologic safety, and functional outcomes.
LEVEL OF EVIDENCE: 5.